Case Western Reserve University has been a leading member of the Multicenter Network of Neonatal Intensive Care Units since 1986. Particular strengths of the Case center include: 1) a large patient population with about 4000 births and 1100 NICU admissions annually with 90% of the population contributed by inborn infants;2) 16 board certified neonatologists and 3 PhD researchers with extensive experience in NIH funded innovative clinical and basic science research;3) faculty dedicated to evidence based medicine with a proven record of collaboration and cohesive care;4)an internationally recognized follow-up program with among the highest retention rates in the Network;5)strong collaborations with our 4 board certified Maternal-Fetal Medicine colleagues;6)exceptional productivity in clinical trials within the network, and 7) demonstrated expertise, leadership and commitment to cooperative research endeavors. Our State Designated Level III perinatal Center includes 69 beds in the Neonatal Intensive Care and Step Down Units, and 18 labor and delivery suites with central fetal monitoring. In 2005 the institution will break ground on a new NICU with enhanced monitoring and an in unit operating room solely dedicated to neonatal surgery. There is a full complement of pediatric medical and surgical subspecialists together with strong nationally recognized programs in respiratory therapy, nursing, genetics, radiology, and pediatric pathology. Our follow-up program is nationally acclaimed and boasts in excess of a 90% follow-up rate. The established computerized neonatal/ perinatal and follow-up data systems have supported a number of studies. We maintain timely and accurate transmission of data to the Data Center. The experienced nurse coordinator and clinical research nurse team ensure high enrollment rates and strict compliance with protocols. Furthermore, both the Division and the Principal Investigator have shown an unusual willingness to collaborate with other scientific groups, both nationally and internationally. The Division of Neonatology and the Intensive Care Units have the physical space, the professional staff, the technology, and the patient population to qualify as one of the premier centers in the Multicenter Network of NICUs. PUBLIC HEALTH RELEVANCE (See instructions): To improve the health of neonates one must conduct large multicenter studies as the population at any single center is not sufficiently large to allow adequate sample sizes for important outcomes. The NRN is the most cost-effective answer to establish the infrastructure to facilitate these trials.